have optimal or ideal levels of health either. International comparisons of infant mortality and life expectancy rates show that the White population of the United States lags behind populations of most major industrialized countries on these health-status indicators—e.g., in 1994, life expectancy for White females in the United States ranked behind that of women in 15 other countries (National Center for Health Statistics, 1998). Nevertheless, because we live in a racially stratified, color-conscious society, where being White can confer significant privileges that non-Whites do not have, Whites can serve as an appropriate, if imperfect, group for comparison with more socially disadvantaged groups.


This section considers differences in age-adjusted death rates from major chronic diseases, infectious diseases, and external causes (murder and suicide) for the various racial groups. For Blacks and Whites, data are available from approximately 1950 to the present, 1980 for American Indians or Alaska Natives and a combined Asian and other Pacific Islander category, and 1985 for Hispanics. Despite the usefulness of mortality data, it must be remembered that they do not provide the same information as data for disease incidence (the number of new cases in a given period) and prevalence (the total number of cases at a given time). Moreover, death certificates are not uniformly accurate in recording either the cause of death or the race of the deceased.

Major Chronic Diseases

Heart Disease

Heart disease is the leading cause of death in the United States. In 1996, it claimed the lives of 733,361 U.S. citizens. Table 14–1A presents age-adjusted death rates1 by race for heart disease between 1950 and 1995. Other than Blacks, all racial groups had death rates lower than those of Whites; Asians and other Pacific Islanders had the lowest rates. Since 1950, there has been a consistent pattern of declining rates from coronary heart disease for both Blacks and Whites. A similar pattern is


Age-adjusted rate: weighted average for age-specific rates, where the weights represent the fixed population proportionate by age. For example, comparing the 1980 death rates for Whites and Blacks, the age-adjusted formula would account for the fact that a certain percentage of Whites were 75 years of age or older, where significantly fewer Blacks were in that age group.

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